ArticleInternational journal of nursing studies2016
Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.
Article in International journal of nursing studies, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01825499 (Vermont Oxford Network Very Low Birth Weight Database of Infants <=1500 Grams or <=29 Weeks Gestational Age at Birth), which is not on this map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Vermont Oxford Network Very Low Birth Weight Database of Infants <=1500 Grams or <=29 Weeks Gestational Age at Birth
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 85 citations in OpenAlex.
- Mothers' experiences of breast milk expression during separation from their hospitalized infants: a systematic review of qualitative evidence.BMC pregnancy and childbirth · 2024Pooled it
- Exclusive Maternal Milk Compared With Exclusive Formula on Growth and Health Outcomes in Very-Low-Birthweight Preterm Infants: Phase II of the Pre-B Project and an Evidence Analysis Center Systematic Review.Frontiers in pediatrics · 2021Pooled it
- Financial Support to Medicaid-Eligible Mothers Increases Caregiving for Preterm Infants.Maternal and child health journal · 2020Trial
- Tolerance of preterm formula versus pasteurized donor human milk in very preterm infants: a randomized non-inferiority trial.Italian journal of pediatrics · 2018Trial
- Human milk and breastfeeding at the first oral feed for infants with critical congenital heart disease: a multi-institutional study.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Impact of Neonatal Intensive Care Unit (NICU) Environment on Maternal Breast Milk Utilization: : A Retrospective Study.Delaware journal of public health · 2026Article
- Maternity care practices supportive of breastfeeding in U.S. advanced neonatal care units, United States, 2022.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Monitoring the Use of Human Milk, the Ideal Food for Very Low-Birth-Weight Infants-A Narrative Review.Foods (Basel, Switzerland) · 2024Review
- An Exploratory Study of the Associations Between the Hospital Work Environment and Implementation of Baby-Friendly Hospital Policy.The Journal of perinatal education · 2022Article
- Association of Patient Acuity and Missed Nursing Care in U.S. Neonatal Intensive Care Units.Medical care research and review : MCRR · 2020Article
- Strategies to increase the use of mother's own milk for infants at risk of necrotizing enterocolitis.Pediatric research · 2020Review
- Quality improvement initiative to improve mother's own milk usage till hospital discharge in very low birth weight infants from a tertiary care NICU.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Prevalence of Exclusive Breast Milk Feeding at Discharge and Associated Factors Among Preterm Neonates Admitted to a Neonatal Intensive Care Unit in Public Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study.Pediatric health, medicine and therapeutics · 2020Article
- Vermont Oxford Network: a worldwide learning community.Translational pediatrics · 2019Review
- How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.Advances in neonatal care : official journal of the National Association of Neonatal Nurses · 2019Observational
- Nursing Care Disparities in Neonatal Intensive Care Units.Health services research · 2018Article
- A Quality Improvement Project to Increase Mother's Milk Use in an Inner-City NICU.Pediatric quality & safetyArticle
- Article
- Missed Nursing Care During Labor and Birth and Exclusive Breast Milk Feeding During Hospitalization for Childbirth.MCN. The American journal of maternal child nursingArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
contextNurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting.
objectivesTo examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. DESIGN AND
settingCross sectional analysis combining nurse survey data with infant discharge data.
participantsA national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997).
methodsSequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support).
resultsThe majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p<0.05). A 1 SD increase (0.15) in the fraction of nurses with a bachelor's degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p<0.05). The acuity-adjusted staffing ratio was marginally associated with the rate of human milk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (p<0.001).
conclusionsNeonatal intensive care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants discharged home on human milk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best nutrition at the point of discharge.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.